NPI | 1134564024 |
---|---|
Former Name | VALERIE CHRISTINE WONDRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: KS 11-02962) |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
Enumeration Date | 2013-05-06 |
Last Update Date | 2024-08-29 |